Friday, October 05, 2012

Bill Aimed at Weakening NY Self-referral Law Vetoed

On Wednesday, New York Gov Andrew Cuomo vetoed legislation that would have weakened existing state restrictions on physicians' ability to refer patients to facilities in which they have a financial interest. Assembly Bill 3551-A would have added some of the same exemptions found in the federal Stark law, such as the in-office ancillary exceptions for certain designated health services.

The New York Chapter has been actively opposing the bill, which was approved by the state legislature earlier this year and sent to the governor in September. The Alliance for Integrity in Medicare—a coalition of provider organizations, including APTA, committed to ending the practice of inappropriate physician self-referral—sent a letter to Cuomo in July asking him to veto the bill.

Comments

Thank you for the APTA and the Alliance for Integrity in Medicare for their support in the Chapters efforts. A strong collaborative unified voice can lead to successes such as this.

Posted by Matthew Hyland
on 10/5/2012 11:50 AM

The big question is, who sponsored the the bill, why he/she sponsored the bill and who is that person affiliated with?

Posted by J Hansen, PT
on 10/5/2012 12:08 PM

Physicain should not be making extra income from
physical therapy services done by physical terapist , I strongly believe no physical therapist should work for the physician owned clinics (POPS). This should not be allowed by APTA.The problem will be solved forever.

Posted by Yalcin Ekren Cert.MDT. PT
on 10/5/2012 11:02 PM

Physical Therapists are the problems because if 10 of them refused to work for MD offices you will find 10 accept to work. So the problem is inside us just any Therpist should blame himself. All MD are making money from PT. Also many Physical Therapists are destroying our profession.

Posted by Ahmed Elmansy -> ?MRa>H
on 10/8/2012 12:29 PM

Should a physician be able to refer to a hospital based PT? Why? Doesn't the hospital pay the physician based on his performance? Do physicians participate in profit sharing plans with the hospital?
I am familiar with the issues surrounding POPS, and where I find myself career wise is being cognizant of ethical issues and monitoring myself and my conduct closely. I work in a small medical practice as a PT, autonomous in every way except my paycheck. The clinic is well equipped for a small clinic, and I accept referrals from outside sources and direct access patients as well.
I determine care plans, based on my own evaluation, and send the evaluations to the referring physicians like anyone else. I fully realize some people have been unethical in this arrangement. When I accepted the position, I made it perfectly clear that I alone determine length, frequency, of treatment. Like any reasonable person, if there is a concern regarding and individual patient, I am more than happy to discuss that patient with a provider and act in the patient's interest.
Don't private practice PTs get more money if they see people longer, more often? That's ethical though? Sounds strange to me... honestly.

Posted by Leon Richard, PT, DPT
on 10/12/2012 6:44 PM

Leon, I agree with you on PTs needing to remain autonomous. But when the arrangement between the MD and PT is financially integrated, whether its a POPTS clinic, private clinic with under table kick backs, or corporation that hires MDs and PTs to work under one roof with a constant stream of referrals...well, that all needs to be looked at, exposed and allowed to be viewed and identified by the patient himself. The patient should be made aware of any and all financial relationships in full disclosure just like is done in other business deals and, ideally, with public elected positions. The patient then can make the decision himself. But there is so much corruption and back room hand shakes in my state, that any law that limits self-referrals is, to me, a good thing.

Posted by Dino Bolos PT, OCS
on 10/12/2012 11:49 PM

Physicians were found to be from 1.7 to 7.7 times as likely to order diagnostic imaging when they owned the equipment in-house. See Kouri, B. et al. Physician Self-Referral for Diagnostic Imaging: Review of the Empiric Literature. American Journal of Roentgenology, vol. 179, October 2002.
Everyone and every profession is capable of corruption. What we do as PT’s is allowed by society, the law, and third-party payers on good faith that we will do it according to the ethical standards of the profession. A physician-owned practice is simply one of the avenues of corruption that can easily be avoided.
The best way to make sure that patient care is entirely up to my ethics, and not influenced by my employer’s productivity standards, is for me to run my own business. So I do. I make my own hours. I decide the intensity of my caseload. I even have a waiting list – no one can say I’m hanging onto a patient for the money.
The less autonomy you have, the more you’ll have someone breathing down your neck for productivity, and unduly influencing your clinical decisions.